Search Results (329)

Background: Cosmetic injection of botulinum neurotoxin type A (BoNT/A) into the submandibular glands is increasingly performed to enhance jawline contour. Although generally considered safe, unintended diffusion of the toxin can impair pharyngeal musculature and lead to dysphagia. Severe aspiration-prone dysphagia after esthetic submandibular gland injection has rarely been described. Case Presentation: A healthy 37-year-old woman developed acute oropharyngeal dysphagia the day after receiving cosmetic contouring injections with incobotulinumtoxinA (Xeomin^®), administered to both submandibular glands (20 units per gland, performed without ultrasound guidance). She presented to our rehabilitation medicine clinic 11 days later with severe difficulty swallowing solids and liquids. Her functional oral intake was severely restricted (Functional Oral Intake Scale [FOIS] score 3), and the Eating Assessment Tool-10 (EAT-10) score was 24. Videofluoroscopic swallowing study (VFSS) demonstrated markedly delayed pharyngeal swallow initiation, reduced palatal elevation, poor airway protection, consistent laryngeal penetration, and silent aspiration of thin liquids (Penetration–Aspiration Scale score 8). She underwent diet modification and structured dysphagia rehabilitation. At three months, repeat VFSS showed substantial improvement, with only occasional penetration of large-volume thin liquids, corresponding to FOIS 5 and EAT-10 score 8. By five months, VFSS confirmed complete resolution of penetration and aspiration with normalization of swallowing physiology, reflected by a FOIS score of 7 and EAT-10 score of 1. Conclusions: This case demonstrates that cosmetic incobotulinumtoxinA injection into the submandibular glands, particularly when performed without ultrasound guidance, can lead to significant oropharyngeal dysphagia. Clinicians performing esthetic lower-face procedures should be aware of this potential complication and ensure timely swallowing evaluation and rehabilitation when symptoms arise. Full article

Background: Anorexia nervosa (AN) may require nasogastric tube (NGT) feeding when oral intake is insufficient. Evidence on the psychological impact and prognostic correlates of NGT use in adolescents affected with AN is limited. Methods: Fifty-seven adolescent inpatients (96.5% female; age range 12–18 years; and mean age 15.0 ± 1.51 years) affected with AN admitted in a child psychiatry ward and treated with NGT re-feeding in addition to oral nutrition were included in the study. A 21-item VAS questionnaire was administered at intake (T0), after NGT introduction (T1), after one week of NGT use (T2), and after NGT dismissal (T3) to assess the physical and psychological effects. Participants were also assessed with psychometric measures including personality (TCI), eating psychopathology (EDI-2), general psychopathology (BDI-II, SCL-90-R, and TAS), and family functioning (FAD). The measures were compared between each timepoint with paired t-tests and ANOVA for repeated measures. Pearson correlations were performed between the VAS scores and psychometric measures. Results: From admission to discharge, weight increased by +3.2 kg and BMI by +1.2 kg/m². Items 1, 3, 4, 6, 15, 18, and 20 of the VAS questionnaire items showed significant improvement over time. TCI personality traits, EDI-2 eating and BDI, SCL-90 and TAS general psychopathology, and FAD family functioning were related to NGT perception by the AN adolescents. Conclusions: NGT was helpful in weight progression during inpatient treatment. It was generally well tolerated, with progressive improvement in psychological and physical discomfort during treatment. The meaningful associations with specific psychometric features suggest the possibility to tailor the NGT use based on adolescent characteristics. Multidisciplinary care and tailored psychoeducation may enhance NGT acceptance. Full article

Background and Objectives: Vaginal natural orifice transluminal endoscopic surgery, vNOTES, has become an increasingly preferred minimally invasive option for benign hysterectomy. General anesthesia is still the routine choice, yet regional methods such as combined spinal epidural anesthesia may support a smoother postoperative course. Although the use of vNOTES is expanding, comparative information on anesthetic approaches remains limited, and its unique physiologic setting requires dedicated evaluation. To compare combined spinal epidural anesthesia with general anesthesia for benign vNOTES hysterectomy, focusing on postoperative nausea and vomiting, recovery quality, and intraoperative physiologic safety. Materials and Methods: This retrospective cohort study was conducted in a single center and identified women who underwent benign vNOTES hysterectomy between March 2024 and August 2025 from electronic medical records. Participants received either combined spinal epidural anesthesia or general anesthesia according to routine clinical practice. All patients were managed within an enhanced recovery pathway that incorporated standardized analgesia and prophylaxis for postoperative nausea and vomiting. The primary outcome was the incidence of postoperative nausea and vomiting during the first day after surgery. Secondary outcomes included time to discharge from the recovery unit, pain scores at set postoperative intervals, early functional recovery, patient satisfaction and physiologic parameters extracted from intraoperative monitoring records. Analyses were performed according to the anesthesia group documented in the medical files. Results: One hundred forty patients met inclusion criteria and were included in the analysis. Combined spinal epidural anesthesia was linked to a lower incidence of postoperative nausea and vomiting, a shorter stay in the post-anesthesia care unit, and reduced pain scores in the first 24 h (adjusted odds ratio 0.32, ninety five percent confidence interval 0.15 to 0.68). Early ambulation and oral intake were reached sooner in the combined spinal epidural group, with higher overall satisfaction also noted. Adherence to ERAS elements was similar between groups, with no meaningful differences in early feeding, mobilization, analgesia protocols or PONV prophylaxis. During the procedure, combined spinal epidural anesthesia produced more episodes of hypotension and bradycardia, while general anesthesia was linked to higher airway pressures and lower oxygen saturation. Complication rates within the first month were low in both groups. Conclusions: In this observational cohort study, combined spinal epidural anesthesia was associated with lower postoperative nausea, earlier recovery milestones and greater patient comfort compared with general anesthesia. Hemodynamic instability occurred more often with neuraxial anesthesia but was transient and manageable. While these findings point to potential recovery benefits for some patients, the observational nature of the study and the modest scale of the differences necessitate a cautious interpretation. They should be considered exploratory rather than definitive. The choice of anesthesia should therefore be individualized, weighing potential recovery benefits against the risk of transient hemodynamic effects. Larger and more diverse studies are needed to better define patient selection and clarify the overall risk benefit balance. These findings should be interpreted cautiously and viewed as hypothesis-generating rather than definitive evidence supporting one anesthetic strategy over another. Full article

Background: This study systematically investigates the therapeutic effects of naringenin (NAR) and oleuropein (OLE) on prostate cancer through miR-155-5p regulation. Methods: Experimental studies conducted on MAT-LyLu prostate cancer cell lines revealed that the application of NAR (50 μM) and OLE (75 μM) significantly increased miR-155-5p expression by 2.89-fold and 1.74-fold, respectively (p < 0.05). Bioinformatics analyses have indicated that miR-155-5p interacts with critical oncogenic pathways such as KRAS, CDK2, NF-κB, and TGF-β/Smad2. Computational analyses have revealed that miR-155-5p interacts with 16 critical oncogenic targets, including KRAS and CDK2. Molecular docking studies showed that NAR binds to the Switch I/II region of KRAS with a binding energy of −8.2 kcal/mol, while OLE binds to the ATP-binding pocket of CDK2 with an affinity of −9.1 kcal/mol. Pharmacokinetic evaluations revealed that NAR indicated high oral bioavailability (93.763% HIA) and full compliance with Lipinski’s rules, while OLE required advanced formulation strategies due to its high polarity. Network pharmacology analyses have shown that NAR affects lysosomal functions and enzyme regulation, while OLE affects G protein-coupled receptors and oxidoreductase activity. Results: Results indicate that NAR and OLE exhibit antitumor effects through multiple mechanisms by increasing miR-155-5p expression and inhibiting critical oncogenic targets in prostate cancer. Conclusion: Findings suggest that the dietary intake of these natural compounds (citrus and olive products) should be considered in prostate cancer prevention strategies, shedding light on the epigenetic mechanisms of polyphenols in cancer treatment and contributing to the development of new therapeutic strategies. Full article

Obesity and metabolic disorders are an increasing concern in companion animals, creating demand for herb-derived nutraceuticals and functional feeds. This study evaluated whether a water extract of Aster pekinensis (AP) ameliorates high-fat-diet (HFD)-induced obesity and metabolic dysfunction in mice. The phytochemical profile of AP was characterized by mass spectrometry, revealing oleanane-type triterpenoid saponins and dicaffeoylquinic acids. Male C57BL/6 mice were fed an HFD and orally given AP (10–200 mg/kg/day) for 12 weeks, with normal diet and untreated HFD groups as controls. AP at 50–200 mg/kg/day reduced body-weight gain, adipose tissue mass and food efficiency without lowering food intake, and improved fasting glucose and atherogenic lipid indices. AP also enhanced glucose tolerance and insulin sensitivity, attenuated hepatic steatosis, hepatocellular ballooning, lobular inflammation and non-alcoholic fatty liver disease (NAFLD) Activity Score, and decreased serum liver enzyme activities. These effects were accompanied by modulation of hepatic genes involved in lipogenesis and inflammation. Together, these findings indicate that AP extract mitigates diet-induced obesity and NAFLD-like liver injury and supports further development as a herb-derived nutraceutical or functional feed ingredient for managing obesity-related metabolic disorders in companion animals. Full article

Beetroot juice (BRJ), a concentrated dietary source of nitrate alongside betalains and polyphenols, influences physiology through enhanced nitrate–nitrite–NO bioavailability, antioxidant activity, and interactions with oral and gut nitrate-reducing microbiota. The efficiency of these mechanisms depends on dose, timing, and preservation of oral bacteria, with antibacterial mouthwash or thiocyanate-rich foods potentially blunting NO₂⁻ generation. Acute BRJ ingestion consistently elevates circulating nitrate and nitrite, yet its impact on glucose, insulin, and lipid regulation is modest; chronic intake may reinforce nitrate-reduction capacity, improve redox balance, and shift microbial composition, though long-term metabolic outcomes remain variable. Cardiovascular adaptations appear more coherent, with acute reductions in systolic blood pressure and improved endothelial function complemented in some cases by microvascular enhancements during multi-week supplementation. Neuromuscular and cognitive effects are less uniform; BRJ does not reliably increase maximal strength or global cognition but may support electrophysiological recovery after muscle-damaging exercise and improve executive performance under fatigue. In exercise settings, dose and timing are critical, as BRJ most consistently benefits endurance performance by reducing oxygen cost, improving exercise economy, and enhancing time-trial or time-to-exhaustion outcomes, whereas effects on sprint, power, and team-sport tasks are more sensitive to contraction duration, recovery intervals, and athlete training status. Overall, available evidence supports a role for NO-mediated vascular and metabolic pathways in the physiological effects of BRJ, although marked inter-individual variability highlights the need for responder-focused dosing strategies and further mechanistic investigation integrating metabolic, microbial, and performance-related outcomes. Full article

Background: Korean red ginseng marc (KRGM), a by-product of Korean red ginseng (KRG) processing, retains numerous bioactive compounds with potential health benefits. Among them, KRGM-derived gintonin (KRGM-gintonin) is particularly rich in lysophosphatidic acid (LPA) and phospholipids, which have been linked to favorable metabolic effects. This study investigated the anti-obesity potential of KRGM-gintonin in high-fat diet (HFD)–induced obese mice, focusing on its impact on weight regulation, liver health, and energy metabolism. Methods: Obese mice (C57BL/6N, 4 weeks, male) were administered KRGM-gintonin either orally for 25 weeks or through intracerebroventricular (ICV) injection for 14 weeks. Throughout the study, body weight, food intake, metabolic parameters, liver tissue morphology, behavioral performance, and thermogenic gene expression were carefully monitored to evaluate treatment effects. Results: Both oral and ICV administration of KRGM-gintonin significantly reduced body weight gain in HFD-fed obese mice without altering food intake, suggesting enhanced energy expenditure. Treatment through both routes improved physical performance and increased metabolic rate. Oral KRGM-gintonin also alleviated fatty liver, reduced plasma triacylglycerol and cholesterol levels, and promoted the expression of thermogenesis-related genes, including uncoupling protein-1 (UCP1) and hormone-sensitive lipase (HSL), specifically in brown adipose tissue. Additionally, oral administration lowered tumor necrosis factor-α (TNF-α) expression, indicating anti-inflammatory activity and further supporting metabolic health. Conclusions: KRGM-gintonin exerts strong anti-obesity effects, primarily through oral administration, with supportive evidence from central ICV action. These findings highlight its potential as a functional therapeutic agent for obesity prevention and management, offering dual benefits in metabolic regulation and inflammation control. Full article

The effects of silk sericin (SS) supplementation on the functionality of chromium picolinate (CrPic) and lipid metabolism were assessed in male Sprague–Dawley rats to determine whether SS improves the bioavailability of CrPic and contributes to beneficial changes in lipid profiles and cardiovascular risk markers. Rats were administered different doses of SS (0, 1, 10, and 100 mg kg⁻¹ body weight (BW)) in conjunction with CrPic (300 µg kg⁻¹ BW) for 8 weeks through oral gavage. Body and organ weights, lipid profiles, glucose levels, chromium (Cr) accumulation, total protein, and adipocyte size were evaluated. Additionally, FTIR analysis was conducted to investigate the binding and release behavior of SS with CrPic. Although body weight and daily feed intake were comparable among groups, a significant increase in pancreas weight and reduction in omentum weight were observed across all CrPic-SS groups. Increased dosages of SS resulted in a significant reduction in triglyceride and plasma glucose levels. All CrPic and CrPic-SS treatments reduced LDL and total cholesterol while increasing HDL. Cr accumulation was elevated in the liver and kidneys of groups administered 10 and 100 mg kg⁻¹ BW of SS, accompanied by a significant increase in total protein levels and a reduction in adipocyte size to less than 50 µm in all rats. FTIR analysis indicated that SS binds to CrPic at pH 2.0 and releases it at pH 7.0, demonstrating pH-dependent delivery similar to the gastrointestinal tract and possibly improved CrPic functionality. These findings indicate that SS improves the bioavailability of CrPic and positively affects lipid metabolism and cardiovascular risk markers in vivo. Full article

Vitamin C, a water-soluble micronutrient, is one of the most widely used dietary supplements pertaining to its vital role in maintaining overall human health, particularly through its potent antioxidant and immune-supportive functions. This mini review summarizes key pharmacokinetic constraints of vitamin C and evaluates formulation strategies aimed at improving its systemic availability. Achieving sustained optimal plasma levels of vitamin C remains challenging due to its dose-dependent absorption, tissue saturation, rapid renal clearance, and short half-life. These pharmacokinetic limitations restrict systemic retention, with high oral doses providing only marginal increases in plasma concentrations and necessitating multiple daily administrations. Conventional vitamin C supplements show efficient absorption only at low to moderate doses, while higher intakes are restricted by transporter saturation and increased renal excretion. Alternative delivery systems such as liposomal encapsulation, esterified derivatives, nano-emulsions, and co-formulations with bioenhancers have been examined; however, evidence for prolonged systemic retention remains inconsistent. The sustained-release formulation of vitamin C shows more reliable outcomes, demonstrating prolonged plasma exposure, higher steady-state concentrations, and potential for improved compliance through reduced dosing frequency. While further robust comparative studies are needed, current evidence suggest that advanced formulation approaches, particularly sustained-release delivery, may help overcome these pharmacokinetic limitations, thereby supporting improved clinical utility of vitamin C supplementation. Full article

The oral microbiome may be an indicator of oral pathologies and hormonal fluctuations. Consequently, the proper identification of methods for studying microbial factors is essential. Because more than half of the components of the oral microbiome belong to species that are very difficult or even impossible to cultivate in the laboratory, the assessment of the oral microbiome nowadays is based on genetic sequencing, using techniques such as DNA hybridization, 16S rRNA sequencing, and metagenomics, mainly analyzing saliva and subgingival plaque. Variations in results may be caused by differences in sample type, analysis methods, accuracy in determining cycle phases, and biases introduced by DNA extraction techniques and technical variations. Choosing the right primers for the 16S rRNA gene and reference databases (like HOMD, Greengenes2) is essential for accurately identifying microorganisms. Metagenomic sequencing offers greater taxonomic and functional detail, but it is costlier and presents bioinformatics challenges, including contamination with human DNA. When the patients under study are women, we have to take into consideration the cyclical changes in the menstrual cycle. Studies suggest that estrogen influences local immune and inflammatory responses and can worsen existing gingival inflammation. Certain oral bacteria can even utilize estradiol and progesterone as growth factors. The composition of the oral microbiome is also affected by hormonal contraceptives, carbohydrate intake, smoking, age, body mass index, genetics, and oral hygiene—all factors that need to be controlled for in future studies. Interpreting the biological significance of the reported cyclic changes requires careful examination of the specific methods used in each study. Full article

Critically ill patients receiving continuous renal replacement therapy (CRRT) face distinct nutritional challenges requiring specialized parenteral nutrition (PN) strategies. This review synthesizes current evidence with clinical expertise to provide a comprehensive nutritional framework for this population. Key findings reveal that CRRT significantly impacts nutrient homeostasis through daily losses of amino acids (14–22 g), water-soluble vitamins, and trace elements via the extracorporeal circuit. Results from observational studies demonstrate that higher protein targets (1.8–2.5 g/kg/day) are necessary to achieve positive nitrogen balance, while energy prescriptions must subtract “hidden” calories from citrate anticoagulation (3–4 kcal/mmol) and propofol (1.1 kcal/mL). Clinical outcome data, though primarily observational, indicate that achieving nutritional adequacy correlates with reduced ICU stays (average reduction 2.1–3.4 days), shorter mechanical ventilation duration, and improved functional recovery. Evidence supports that early PN prescription when indicated, coupled with systematic consideration of therapy modality, extracorporeal losses, oral intake capacity, and mobilization status, optimizes nutritional support. We conclude that successful implementation requires: (1) dynamic adjustment based on CRRT parameters, (2) integration with enteral nutrition when feasible, (3) regular metabolic monitoring, (4) multidisciplinary collaboration, and (5) structured protocols. Future research using point-of-care analysis and AI-driven support systems is needed to establish evidence-based guidelines in this specialized population. Full article

Background/Objective: Aging is associated with a decline in metabolic health, including impaired glucose regulation. Both diet and biological sex impact metabolic health, yet sexual heterogeneity in diet response is understudied. We report on exploratory analyses of sex-specific associations between diet and insulin sensitivity, insulin resistance, and android and intermuscular fat composition in older adults. Methods: This secondary analysis uses baseline data from a previously completed clinical trial (n = 96), the MASTERS study. An oral glucose tolerance test (OGTT) was used to calculate insulin resistance and insulin sensitivity as measures of metabolic function, while dual-energy x-ray absorptiometry and computed tomography were used to assess body composition. Univariate analyses were used to identify sex-specific associations between metabolic health and single nutrients, as well as other dietary components. Feasible solutions algorithm (FSA) modeling was employed to identify food groups that were most associated with insulin sensitivity. Results: In men, greater intakes of vegetable protein (p < 0.0001) and whole grains (p = 0.001) were associated with higher insulin sensitivity, while refined grains (p = 0.003) and conjugated linoleic acids (p < 0.001) were negatively associated. In women, insulin sensitivity was positively associated with alcohol (p < 0.001) and xylitol (p = 0.007). FSA modeling identified whole grains, nuts, and seeds as food groups that predicted higher insulin sensitivity in men, while alcohol remained the strongest predictor in women. Conclusions: Men showed higher insulin sensitivity with plant-based diets, while alcohol intake was the dietary factor most associated with insulin sensitivity in women. The findings of these exploratory analyses support the need for sex-specific clinical trials and dietary guidance for aging populations. Full article

Background: Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity, often necessitating extensive surgical resection. Such interventions may result in complex intraoral defects requiring immediate reconstruction to restore function and aesthetics. Objective: This case report highlights the surgical management of a patient with OSCC involving the tongue, floor of the mouth and mandibular ridge, reconstructed using a radial forearm free flap (RFFF). Case report: A 51-year-old male with a history of heavy smoking presented with a necrotic lesion affecting the left mandibular alveolar ridge, floor of the mouth, and tongue. Methods: Histopathological examination confirmed a diagnosis of moderately differentiated keratinizing OSCC (G2). After oncologic resection and selective neck dissection, the defect was reconstructed using an RFFF harvested from the left forearm. The facial artery and anterior jugular vein served as recipient vessels for microvascular anastomosis. A split-thickness skin graft (STSG) was used to close the donor site. Results: The postoperative course was generally favorable. Minor complications, including a localized hematoma and neck wound dehiscence, were conservatively managed. Functional outcomes such as oral intake and wrist mobility were successfully restored with rehabilitation. The RFFF provided durable, well-vascularized coverage over exposed mandibular bone, critical for minimizing the risk of osteoradionecrosis in the context of planned adjuvant radiotherapy. Conclusions: The radial forearm free flap remains a reliable reconstructive option for complex oral defects post-OSCC resection. Multidisciplinary collaboration and meticulous surgical technique are essential to achieve optimal oncologic, functional, and aesthetic outcomes. Full article

Background/Objectives: Chronic diseases linked to obesity represent a major global health challenge. Although pharmaceutical treatments show efficacy, their use is often limited by side effects. Methods: This study investigated the anti-obesity effects of acid-processed Citrus reticulata Blanco peels extract (CRBE) prepared through reflux extraction with 50% ethanol, followed by acid treatment using 3 M hydrogen chloride and neutralization. Results: Following acid treatment, the composition of the extract showed a marked increase in the 5-demethylated forms of polymethoxyflavones, particularly 5-demethylnobiletin (31.86 mg/g) and 5-demethyltangeretin (34.68 mg/g), whereas the concentrations of the typical citrus polymethoxyflavones, nobiletin (14.82 mg/g) and tangeretin (10.61 mg/g), decreased. Using 3T3-L1 preadipocytes, CRBE inhibited adipogenesis concentration dependently, substantially decreasing the expression of adipogenic transcription factors and lipid metabolism-related proteins. In ob/ob mice, oral CRBE substantially suppressed body weight gain without affecting food intake, while normalizing liver function indicators and improving serum lipid profiles by reducing total cholesterol, triglycerides, and low-density lipoprotein. Conclusions: Acid-processed CRBE effectively inhibits adipocyte differentiation and exhibits anti-obesity effects in vivo, offering potential as a natural agent for obesity management with minimal side effects. Full article

Cancers induced by human papillomavirus are often associated with systemic inflammation and cachexia. This study aimed to determine the interference of Pennisetum glaucum oral supplementation over multi-organic dysfunction in HPV16-transgenic mice. The experimental groups included (1) wildtype (WT) mice with standard diet, (2) WT mice with 36% Pennisetum, (3) transgenic mice with standard diet, (4) transgenic mice with 29% Pennisetum, and (5) transgenic mice with 36% Pennisetum. During the 4-week experimental protocol, body weight, food and water intake, and humane endpoints were recorded. At sacrifice, blood and tissue samples were collected for analysis. Oral supplementation with millet was shown to be safe and well tolerated by both WT and transgenic mice, with no adverse effects on behavior, food or water intake, or general animal welfare. In HPV16-transgenic animals, millet supplementation was associated with an improved health status, reduced serum glucose levels, enhanced antioxidant responses, and a notable reduction in the severity of HPV-induced skin and organ lesions. Overall, Pennisetum glaucum was safe under these experimental conditions and is a promising functional food for patients suffering from systemic paraneoplastic syndromes. Longer exposure periods and doses should be evaluated experimentally before proceeding to clinical trials of Pennisetum-containing diets. Full article